Oncology pharmacist-led medication reconciliation among cancer patients initiating chemotherapy.
This study evaluated changes made to the electronic health record (EHR) resulting from pharmacist-led medication reconciliation among patients initiating chemotherapy. Most of the included oncology patients had a medication change identified after medication reconciliation, thereby ensuring physician orders were captured and improving medication safety. Medication changes commonly involving vitamin and herbal supplements (medication additions and modifications) and antimicrobials (medication discontinuations).